CONNELLAN: Time for N.J. to subsidize EMS system

If I asked you what is a paramedic or EMT (Emergency Medical Technician) would you be able to answer correctly? How about the differences between ALS (Advanced Life Support) and a BLS (Basic Life Support)? Probably not. How about why ALS and some BLS agencies bill you and your insurance and why is the bill so high? Let me try to explain.

Let’s say you to go to your doctor’s office. Before you see the doctor you are required to present your ID, insurance card and copay. Your insurance gets billed and you are responsible for whatever balance or co-pay is due. Do you expect that you will not have to pay for services rendered? Of course not. In New Jersey, you only pay for EMS if you use it.

New Jersey is a user-based EMS system, meaning most ALS projects receive zero subsidization from any entity, local, county or state. The person who uses the EMS service and their insurance company are responsible for the cost of the services they use. Private BLS EMS agencies licensed by the state also receive no funding other than reimbursement through billing the patients they treat and and/or transport. Licensed municipal police- or fire-run EMS systems have the ability to waive a patient’s copay and absorb the excess non-billable costs due to municipal tax bases.

Tax subsidy for police and fire services in New Jersey is a law. Look at your municipal tax bill. Education, police, fire, etc. No EMS. In New Jersey there is no law or written mandate that states if you call 911 and need an ambulance, you are to get one and in a timely fashion? As a taxpayer, this should make you very angry.

ALS (Paramedics) are legally mandated to be up and running 24/7, 365 days a year, and report directly to the state Department of Health.

The primary area covered by one of the Mobile Intensive Care Units I work on out of Neptune covers 185,535 residents. This does not include the mutual aid responses into our two neighboring MICUs, or those just passing through the area, visiting, vacationing, etc. That leaves two paramedics to provide ALS EMS care for close to 250,000 people.

The time has come for EMS to be recognized as a necessary service in New Jersey, therefore allowing them access to government subsidization to help keep these projects up and running. Currently, ALS projects have to absorb the cost of patients who use the EMS system and have no ability to pay.

Privately run ALS agencies are literally hemorrhaging money to keep their systems up and running to meet patients’ needs in the face of drastically reduced insurance reimbursement, increased cost of medications and operational costs. On top of that, ALS and BLS agencies across the state are now forced to compete for mere scraps of the same reduced insurance reimbursement. The 2018 EMS system is not working for any patient or provider in this state.

The population in New Jersey in July 2017 was 8,791,953, and there are only about 1,500 practicing paramedics in the state.

The “this is the way we have always done it” mentality and “status quo” of a broken EMS system is no longer justifiable or acceptable. Exceptional pre-hospital health care should become paramount in NJ, not an afterthought to political correctness.

Since 1980s the ALS Certificate of Need has been in place with minimal changes. ALS projects unable to keep up with the exorbitant cost of salaries, benefits, provider training, vehicle and equipment maintenance and operating costs have come and gone. Mergers and acquisitions have happened. Yet, still no assistance at the state level. There needs to be an educated and informed discussion on government subsidization to EMS agencies that provide the services required by law in New Jersey.

Our population has doubled, life expectancy has increased, cost-of-living expenses are exorbitant and volunteer ranks are diminished. Paramedics are retiring or leaving the state and mobile health care is in drastic need of change.

This year needs be the year Gov. Phil Murphy and our newly elected officials to breathe some life into New Jersey’s antiquated EMS system.

Tracy J. Connellan, of Wall, is a life member of a volunteer EMS agency and a paramedic for MONOC. She formerly served on the state Emergency Medical Care Advisory Board (EMCAB).